A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings?

Answer: A. “Syncope episodes may occur when taking this medication.”

Rationale:

A) “Syncope episodes may occur when taking this medication.”
Syncope (fainting) is a possible side effect of donepezil, a cholinesterase inhibitor used to treat Alzheimer’s disease. Donepezil can cause bradycardia, which may lead to a decrease in blood pressure and reduced blood flow to the brain, resulting in syncope. It's important for family members to monitor for episodes of dizziness, fainting, or lightheadedness, particularly when the client changes positions (orthostatic hypotension).

B) “You will need to monitor for constipation.”
Constipation is not commonly associated with donepezil use. In fact, donepezil may cause diarrhea or gastrointestinal upset due to its cholinergic effects. Family members should be more concerned about potential gastrointestinal disturbances such as nausea, vomiting, or diarrhea rather than constipation.

C) “This medication may cause tachycardia.”
Donepezil is more likely to cause bradycardia (a slower-than-normal heart rate) rather than tachycardia (a fast heart rate). Bradycardia is a known side effect because the medication increases acetylcholine, which enhances parasympathetic activity, leading to a slower heart rate.

D) “You should administer the medication each morning.”
Donepezil is typically administered in the evening before bed. This schedule helps reduce the risk of daytime gastrointestinal side effects, like nausea and vomiting, which can interfere with daily activities. Administering the medication at night can also reduce the impact of potential dizziness or syncope during the day.

A) The parasympathetic nervous system:
This is the correct answer. The parasympathetic nervous system is responsible for regulating rest and digestion. It controls activities such as increased gastric motility, secretion of digestive enzymes, and relaxation of sphincters in the gastrointestinal tract. Activation of the parasympathetic nervous system promotes digestion and absorption of nutrients by increasing gastrointestinal activity.

B) The limbic system:
The limbic system is primarily involved in emotions, behavior, and long-term memory formation. While emotions can influence gastrointestinal function, including appetite and digestion, the limbic system itself does not directly control gastric motility and digestion.

C) The central nervous system:
The central nervous system includes the brain and spinal cord and plays a vital role in integrating and coordinating all body activities. While it indirectly influences gastrointestinal function through autonomic nervous system control, it is not the primary regulator of gastric motility and digestion.

D) The sympathetic nervous system:
The sympathetic nervous system is responsible for the body's fight or flight response, which involves activities such as increasing heart rate, dilating airways, and redirecting blood flow away from the digestive organs to skeletal muscles during times of stress or arousal. It typically inhibits digestive processes, including gastric motility, to conserve energy for immediate survival needs.